An influencer evangelist spreading Robert F. Kennedy Jr.’s MAHA agenda won’t be America’s next surgeon general. Close Kennedy ally Casey Means is no longer Trump’s nominee for the role, and the president announced on Thursday that he would push for Dr. Nicole Saphier, a radiologist who specializes in breast cancer, to serve as the country’s top doctor instead.  After she was nominated, Means faced questions about her track record on vaccines, children’s health, and her own qualifications for the role, which is historically held by a practicing physician. Her nomination ultimately stalled after facing opposition from Republicans who refused to back her for the role, including Alaska Sen. Lisa Murkowski. Means, a 38-year-old wellness influencer who does not currently hold an active medical license, graduated from the Stanford University School of Medicine but left her surgical residency program early. Means said she abandoned her training to “focus on the real root causes of why Americans are so sick,” which for her meant co-founding a health startup for monitoring blood glucose and cashing in on the social media wellness craze through paid promotions. Moving beyond means  Trump’s former surgeon general nominee reined in some of her more extreme views after being tapped for the role, but the internet lives forever. Prior to being scrutinized as a soon-to-be high-ranking government official, Means slammed the widespread use of hormonal birth control as a “disrespect of life,” called the practice of giving newborns the hepatitis B vaccine “absolute insanity,” and derided Americans’ use of GLP-1 medications—a stated health priority of Trump himself. Even with her nomination clearly on the rocks, Kennedy remained all-in on Means. “Casey Means is the most articulate, eloquent, and erudite evangelist for the MAHA movement,” Kennedy declared last month during a House committee hearing, calling on lawmakers to throw their weight behind her. Trump’s new nominee might not be Kennedy’s preferred pick, but she did write a book titled Make America Healthy Again back in 2020. In that book and others, Saphier emphasizes the power of lifestyle changes like diet and exercise, two major areas of emphasis for the MAHA movement. Unlike Means, Saphier is a practicing doctor, a plus that Trump is emphasizing, given Means’s lack of credentials. “Nicole is a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment while tirelessly advocating to increase early cancer detection and prevention,” Trump wrote in a Truth Social post on Thursday. What does it mean for MAHA? Ultimately, Means’s skeptical views on vaccines likely dealt the killing blow to her nomination. Murkowski pressed the nominee on her views about vaccination during a confirmation hearing earlier this year, but Means stopped short of explicitly endorsing childhood vaccines. Senate Health Committee Chair Bill Cassidy (R-LA) and Sen. Susan Collins (R-ME) also opposed Means’s nomination, according to a report from Politico . “Three Republican senators chose to block my nomination moving through the health committee,” Means told the publication. “In doing so, [they] really put a vote towards the status quo, rather than rise into this monumental occasion to work to evolve our broken healthcare system and have a bigger conversation about why Americans are so sick.” On Truth Social, Trump criticized Cassidy, calling him a “very disloyal person” for opposing Means. “I nominated Casey, a strong MAHA Warrior, at the recommendation of Secretary Kennedy, who understands the MAHA movement better than anyone, with perhaps the possible exception of ME!” Means’s nomination was ultimately doomed, but Trump didn’t put any distance between himself and the failed nominee. On Truth Social, Trump continued to praise Means and named shared concerns like the “rising childhood disease epidemic, increased autism rates, poor nutrition, over-medicalization, and researching the root causes of infertility” among the MAHA priorities that his administration will focus on. What the failed nomination means for Kennedy’s MAHA agenda is far from clear. Kennedy’s policy changes have faced vocal opposition and dire warnings from doctors and public health experts. His ideas about how to fix Americans’ health woes aren’t popular beyond Trump’s base and have even inspired a wave of doctors to dive into politics for the first time—a trend worth tracking come the midterm elections.